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Medical Unit Coordinator
2 months ago
Montefiore Medical Center is seeking a skilled Registered Nurse (RN) to fill a Case Management position in our Englewood Cliffs, New Jersey location.
Job Summary:We are looking for a dedicated and compassionate RN to coordinate the continuum of medical care services for patients, ensuring optimum utilization of resources, delivery of quality patient care, and compliance with regulatory, accrediting, and contractual requirements.
Responsibilities:- Coordinates patient care services to ensure efficient use of resources and delivery of quality care.
- Prepares clinical appeals for third-party denials and collects and interprets data for utilization, compliance, QI, and other areas as assigned.
- Determines the appropriateness of patient care services and ensures compliance with regulatory and contractual requirements.
- Collaborates with healthcare professionals to develop and implement patient care plans.
- Monitors and evaluates patient outcomes to ensure quality care and identifies areas for improvement.
- BSN or a bachelor's degree in a related field required; Master's preferred.
- 3-5 years of recent acute care clinical experience preferred.
- Experience in utilization management and case management preferred.
- Certification in Utilization Review or Case Management preferred.
- Demonstrated knowledge of federal, state, and commercial/third-party regulations related to utilization management functions, discharge planning, and associated processes.
- Demonstrated knowledge of quality/performance improvement tools and techniques.
- Demonstrated knowledge of utilization and case management principles.
- Excellent organization, teamwork, and time management skills.
- Expert clinical knowledge of disease processes to identify care needs.
- Understanding of the healthcare delivery system and its sites of care, delivery models, and the roles of various providers and healthcare professionals.
Montefiore Medical Center is an equal opportunity employer and welcomes applications from diverse candidates. We offer a competitive salary and benefits package, as well as opportunities for professional growth and development.
Montefiore Medical Center is committed to diversity, equity, and inclusion and is an affirmative action/equal opportunity employer. We are proud to be a leader in clinical care, healthcare research, education, and social commitment.
